Legal & Ethical - Adverse Outcomes - Case Review on the ICU

Chris Danbury

Consultant Intensive Care Physician , University Hospital, Southampton

Chris has over 30 years’ experience as a doctor, training initially in general internal medicine, microbiology/virology and anaesthesia before switching to intensive care medicine. In 2002, he was appointed as consultant intensive physician at the Royal Berkshire Hospital. He moved to University Hospital Southampton in December 2020; his practice is in General and Neuro Intensive Care Medicine.

He holds academic roles at the University of Southampton, Kings College London and the University of Reading. His research interests are in complex decision-making related to serious medical treatment, and he has been awarded an Honorary Fellowship of the Faculty of Forensic and Legal Medicine for exceptional services to the science and practice of Forensic and Legal Medicine.

Chris has been Honorary Secretary of the Intensive Care Society, founded and Chaired the Legal and Ethical Policy Unit of the Faculty of Intensive Care Medicine and been a member of national guideline development groups in a number of key areas, including Prolonged Disorders of Consciousness.

Dr Thearina de Beer

Consultant Intensivist and Anaesthesia, Nottingham University Hospitals NHS Trust

Dr Thearina de Beer MBChB FRCA DICM FFICM LLM (Health Law) RCPathME , is a Consultant in Anaesthetics and ICM including Neuro-ICM at Nottingham University Hospitals. Thearina is currently Divisional Director for the Clinical Support Division. She is a Medical Examiner at NUH and is deputy lead ME for NUH. She is on the ICS – Legal and Ethical Advisory Group. Her special interests are delirium and the impact on long stay patients, legal and ethical issues around critical and neuro-critical care.

Helena Durham

Helena Durham is a lay member of the Ethics of Clinical Practice Committee at Nottingham University Hospitals NHS Trust and a patient/carer representative on the Trust's Mortality and End of Life Care Group. 

Dan Harvey

Professor of Intensive Care Medicine , UK

Dr Dan Harvey is a Consultant in Intensive Care Medicine at Nottingham University Hospitals, Hon. Professor at the University of Nottingham, and a member of the UK Intensive Care Society Legal & Ethical Advisory Group. Dan has an active research interest as National Lead for Innovation & Research in Organ Donation for NHS Blood and Transplant, and joint Chief Investigator for the SIGNET study, the world's largest interventional study in organ donation.

Jenny Kitzinger

Co-Director, Coma and Disorders of Consciousness Research Centre, UK

Professor Jenny KItzinger is co-director of the Coma and Disorders of Consciousness Research Centre at Cardiff University (cdoc.org.uk) - a multi-disciplinary group of researchers exploring the ethical, legal and social dimensions of vegetative and minimally conscious states. She is co-author of multiple papers about the decision-making process around life-sustaining treatment and particularly the place of a person’s own values in ‘best interests’. This work has informed online training for healthcare professionals (cdoctraining.org.uk) and a website resource for patients’ families (healthtalk.org) which has been used by over 50,000 people and won a BMA award for its information on ethical issues.  

: @JennyKitzinger

Nina Lewis

Dr Nina Lewis is a consultant physician and honorary assistant professor of gastroenterology at Nottingham University Hospitals NHS Trust. 

At East Midlands’ largest specialist oncology unit, she is the lead gastroenterologist responsible for providing expert opinion on the assessment and management of cancer treatment complications on the gut. Dr Lewis also provides supra-specialist assessment and care of gut complications following bone marrow transplant treatments for haematological cancers. 

As an expert in diagnosing cancer, Dr Lewis introduced to Nottinghamshire the suspected cancer of unknown primary clinical pathway to help achieve an earlier diagnosis of cancer regardless of a person’s mode of presentation.

Following formal training in her lectureship, she has a busy IBD clinical practice which supports national observational genotype studies.

Dr Lewis is an experienced medical examiner and has undertaken independent scrutiny on over 3000 deaths for the Nottingham Medical Examiner Service.  

Rob Tobin

Partner, Kennedys Law

Rob is a medical lawyer with over 25 years’ experience. He leads Kennedys’ large healthcare team in Cambridge and is the firm’s Head of Medical Law. He is a strong advocate of advance care planning, keen to ensure autonomy and the individual remain at the heart of all medical decision-making. He advises NHS Trusts on all aspects of medical law, including medical negligence litigation; serious medical treatment decisions; end of life decisions; deprivation of liberty; judicial reviews; consent and capacity to treatment; and mental health law. He and his team advocate on behalf of healthcare organisations at coroners’ inquests, including complex Article 2 and Jury inquests. Rob lectures on mental health; mental capacity; medical treatment decisions; inquests; deprivation of liberty; and consent and writes articles on these subjects. He is the legal advisor to the Intensive Care Society’s Legal, Ethics and Advisory Group and is a member of the Cambridge University Hospital ethics committee. He sat on the Academy of Medical Royal Colleges’ Working Group drafting the 2025 Code of Practice for the definition and confirmation of death (2025). During the pandemic, Rob advised the National Executive Critical Care Committee on legal and ethical issues concerned with the treatment of patients in the NHS. Rob is a Trustee of North London Hospice.

Recent case highlights include:

Norfolk and Norwich University Hospitals NHS Foundation Trust & Ors v Tooke & Ors – Rob acted for 2 NHS Trusts in this case concerning Jordan Tooke, a 29 year old man with learning disabilities in need of dialysis and a kidney transplant, provision of which would potentially require restraint and sedation (up to GA) 3 times a week.

Patricia's Father & Ors v Patricia (by her litigation friend, the Official Solicitor) & Ors [2025] EWCOP 30 (T3) - Rob acted for the mental health trust in this high profile matter concerning a young person with a severe eating disorder alongside a personality disorder. The case concerned whether long term enforced treatment, to include restraint for NG feeding, could be provided in her best interests.

Cambridge University Hospitals NHS Foundation Trust (1) and Cambridgeshire & Peterborough NHS Foundation Trust (2) v RD 2022 – acting for the Trusts where a young adult in her mid-20s had fluctuating capacity. She was in a cycle of self-harm to such extent the High Court agreed it was in her best interests to provide no further lifesaving treatment in the event she self-harmed again and required such treatment, despite the fact life-saving treatment was available.

Cambridge University Hospitals NHS Foundation Trust v AH 2021 - Rob acted for the Trust in the very high profile case obtaining a declaration it was no longer in P’s best interests to receive ventilatory support and it was lawful for that to be withdraw. This case went to the Court of Appeal and concerned a 56 year old patient, who “in terms of the neurological impact and complications” was described as “the most complex COVID-19 patient in the world”.

Tafida Raqeeb v Barts Health NHS Trust and others 2019 – Rob acted for Barts in complex Judicial Review and medical treatment case concerning withdrawal of life sustaining treatment for 5 year old Muslim child, whose parents sought to take her to Italy for ongoing medical treatment.